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Hemostasis in spontaneous subarachnoid hemorrhage
Y Fujii1, S Takeuchi, O Sasaki
1Department of Neurosurgery, Kuwana Hospital, Niigata, Japan.
Neurosurgery
|August 1, 1995
Summary
Early activation of blood coagulation and fibrinolytic systems occurs after subarachnoid hemorrhage (SAH). These hemostatic changes correlate with neurological severity, clot burden, and poorer clinical outcomes in SAH patients.
Area of Science:
- Neuroscience
- Hematology
- Critical Care Medicine
Background:
- Spontaneous subarachnoid hemorrhage (SAH) is a critical neurological event.
- Hemostatic system activation is suspected early after SAH but requires detailed examination.
Purpose of the Study:
- To investigate early changes in hemostatic systems post-SAH.
- To correlate these hemostatic changes with neurological status, imaging findings, and patient outcomes.
Main Methods:
- Review of 167 patients admitted within 24 hours of SAH onset.
- Detailed examination of hemostatic systems, including thrombin-antithrombin complex, plasmin-antiplasmin complex, and D-dimer levels.
- Correlation analysis with neurological severity, CT findings, and clinical outcomes.
Main Results:
- Elevated thrombin-antithrombin complex, plasmin-antiplasmin complex, and D-dimer levels correlated with increased neurological severity, clot burden, and poorer outcomes.
- Higher levels of thrombin-antithrombin and plasmin-antiplasmin complexes were observed in patients with intracerebral or intraventricular hematomas.
- Thrombin-antithrombin complex levels were significantly higher in patients with poor outcomes across various neurological and CT grades.
Conclusions:
- Early activation of both blood coagulation and fibrinolytic systems occurs in SAH.
- The extent of hemostatic system activation is associated with the severity of SAH, as indicated by neurological and CT findings.
- Hemostatic system activation is a significant predictor of clinical outcome in SAH patients.